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Efficacy and safety of apixaban vs warfarin in patients with atrial fibrillation and extremes in body weight: Insights from the ARISTOTLE trial

Circulation Feb 24, 2019

Hohnloser SH, et al. - Among 18,139 patients with available weight and outcomes data from the ARISTOTLE (n=18,201) trial (a randomized trial of apixaban vs warfarin to prevent stroke in AF patients), researchers assessed how body weight (≤60, >60-120, >120 kg) impacted the randomized treatment effect (apixaban vs warfarin). For this purpose, they used a Cox regression model. The low weight group (≤60 kg) comprised 1,985 (10.9%) subjects, the mid-range weight group (>60-120 kg) 15,172 (83.6%) subjects, and the high weight group (>120 kg) 982 (5.4%) subjects. Across the spectrum of weight, including in low (≤60 kg) and high weight patients (>120 kg), the efficacy, as well as the safety of apixaban, was evident. Across weight groups, apixaban's superiority over warfarin was reported with respect to efficacy and safety outcomes, with even greater reductions in major bleeding in AF patients with low-normal weight vs high weight. Regarding efficacy and safety for stroke prevention, apixaban's superiority over warfarin appeared similar across all weight groups, including in the low and very high weight patients. Overall, regardless of body weight, apixaban appeared appropriate for patients with AF.

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